Abstract
Breast reconstruction in extensive post-mastectomy defects is challenging for a reconstructive surgeon. While a plethora of options is available for breast reconstruction, pedicled latissimus dorsi (LD) flap remains the flap of choice for most surgeons. However, the size of the skin paddle of the LD flap may not suffice for extensive defects. We present a technical modification in the planning of the LD flap for its use in extensive defects.
Highlights
Breast reconstruction is an integral part of breast cancer surgery, aimed at correcting the chest wall defect and symmetry
Various techniques have been implemented for the reconstruction of the breast: latissimus dorsi (LD) flap, transverse rectus abdominis myocutaneous (TRAM) flap, deep inferior epigastric artery perforator (DIEP) flap, implant, various locoregional, and microvascular free flaps [1]
We report a case of carcinoma breast with an extensive post-mastectomy defect, resurfaced with a pedicled LD myocutaneous flap with an S-shaped skin paddle, allowing primary closure of the donor site
Summary
Breast reconstruction is an integral part of breast cancer surgery, aimed at correcting the chest wall defect and symmetry. Extensive post-mastectomy defects, pose a great challenge to the reconstructive surgeon It may require a single large free/pedicled flap or a combination of free/pedicled flaps to resurface the extensive defect, which may result in higher donor site morbidity and other complications [3,4]. We report a case of carcinoma breast with an extensive post-mastectomy defect, resurfaced with a pedicled LD myocutaneous flap with an S-shaped skin paddle, allowing primary closure of the donor site. The patient’s backroll with maximum laxity was present in the middle of the LD flap territory, going oblong, where the middle part of the S-shaped was planned and marked Keeping this flap in the pinched position where primary closure can be achieved, superior and inferior limbs of the S-shape were planned, allowing primary closure of the skin on the donor site. The patient received adjuvant radiotherapy after four weeks post-surgery (Figure 6)
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